Issue Brief 19-36
December 27, 2019

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule to increase the oversight and fiscal integrity of Medicaid by addressing a number of financing structures and mechanisms, including:

  • fee-for-service provider payments, particularly supplemental payments
  • disproportionate share hospital payments
  • sources of the non-federal share

Within each area, the proposed rule would require additional data reporting, clarify definitions and regulatory language, modify state administrative procedures, limit state flexibility, and implement more rigorous requirements. The overarching goal is to reduce questionable financing mechanisms.

This Issue Brief summarizes major provisions of the proposed rule. Comments on the proposal were initially due January 17, 2020, but CMS extended the comment period to February 1, 2020.